hMLH1、hMSH2、hMSH6在中青年散发性结直肠癌中的表达及对预后的影响
Expressions of hMLH1,hMSH2 and hMSH6 in young and middle-aged patients with sporadic colorectal cancer and its effect on prognosis

目的:探讨hMLH1、hMSH2、hMSH6在中青年散发性结直肠癌(SCC)中的表达及对预后的影响。方法:采用免疫组化法检测96例中青年SCC组织中hMLH1、hMSH2、hMSH6的表达情况,分析这3种错配修复蛋白(MMR)表达缺失与患者临床病理特征及预后的关系。结果:hMLH1的表达缺失率为20.8%(20/96),hMSH2的表达缺失率为8.3%(8/96),hMSH6的表达缺失率为7.3%(7/96),MMR总表达缺失率为28.1%(27/96)。MMR表达缺失在pTNM分期、肿瘤部位、肿瘤直径、淋巴结转移和大体类型间的差异均有统计学意义(P<0.05)。MMR表达缺失组的5 a无病生存率为77.8%(21/27),高于MMR正常组46.4%(32/69),差异有统计学意义(χ2=8.955,P=0.003)。MMR表达缺失组的5 a总生存率为85.2%(23/27),高于MMR正常组49.3%(34/69),差异有统计学意义(χ2=12.009,P<0.001)。单因素和多因素分析显示,MMR状态是影响SCC患者无病生存时间和总生存时间的危险因素。结论:中青年SCC患者MMR表达缺失组患者较MMR正常组患者预后好。
Aim: To discuss expressions of hMLH1, hMSH2 and hMSH6 protein in the young and middle-aged patients with sporadic colorectal carcinoma(SCC)and their effects on prognosis.Methods: Immunohistochemistry was used to detect the expressions of hMLH1, hMSH2 and hMSH6 in 96 cases of SCC specimens.The relationship between expression of the mismatch repair protein(MMR)and clinical pathological features and prognosis.Results: The deletion expression rate of hMLH1, hMSH2 and hMSH6 was 20.8%(20/96),8.3%(8/96),and 7.3%(7/96), respectively.The total deletion expression rate of MMR was 28.1%(27/96).The deletion expression of MMR was significantly related with pTNM stage, tumor site, tumor diameter, lymph node metastasis and gross type(P<0.05).The five-year disease-free survival rate was 77.8%(21/27)in the MMR deletion expression group and 46.4%(32/69)in the normal MMR group, and the difference was significant(χ2=8.955, P=0.003).The five-year overall survival rate was 85.2%(23/27)in the MMR deletion expression group and 49.3%(34/69)in the normal MMR group, and the difference was significant(χ2=12.009, P<0.001). The univariate and multivariate analysis showed that MMR status was risk factor influencing disease-free survival and overall survival time in patients with SCC.Conclusion: The young and middle-aged SCC patients with MMR deletion expression have better prognosis than those with normal MMR expression